| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,629.00 | $3,600.00 | $12,154.00 | |
Aetna
| Professional | $1,361.00 | $2,624.00 | $7,655.00 | |
Cigna
| Facility | $624.00 | $624.00 | $624.00 | |
Medica
| Facility | $166.00 | $526.00 | $1,713.00 | |
United
| Facility | $376.00 | $853.00 | $1,915.00 |